Wholesale Application Form

Business Name*
Business Address*

Street Address Line 1

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Your Name*

First NameLast Name
Intent*

eCommerceBrick & Mortar LocationBoth
Website URL*
E-mail*
example@example.com
Reseller Permit Copy*

Please upload a copy of your resale certificate.
Cancelof
Shipping Account #
If you would like us to bill your corporate account-if not leave blank
Shipping Address (if different from Business Address)

Street Address Line 1

Street Address Line 2

CityState

Zip CodeCountry
What products are you most interested in?*

Art printsCompact MirrorsArt pendantsOther
I understand a submitted application does not indicate automatic acceptance into the Morgan Cerese Art Wholesale Program.*

I understand
I agree that Morgan Cerese Art products are not to be sold under any other brand. Morgan Cerese Art branding will not be removed from the product packaging.*

I agree to these terms
If accepted, I understand that any sample requests as well as the first order is to be prepaid.*

I understand
Please verify that you are human*
Should be Empty: